High Court reminds regulators how they must approach fairness, evidence, and proportionality in fitness to practise decisions

The High Court’s judgment in Nurrish v Nursing and Midwifery Council [2026] EWHC 2 (Admin) is one of those deceptively modest Administrative Court decisions that ends up having outsized influence. It didn’t rewrite the law—but it sharpened it. It reminded regulators that disciplinary justice is not a rubber‑stamp exercise, and that registrants are entitled to rigorous, balanced, and evidence‑based decision‑making.

Mr Justice Eyre quashed a Nursing and Midwifery Council (NMC) review panel’s decision to strike a nurse off the register, remitting the matter to a fresh panel for reconsideration — underscoring that process, fairness and evidential rigor matter as much as outcomes in regulatory proceedings.

At its heart, Nurrish is about how professional regulators must think, not just what they must decide.

Background: from suspension to striking-off

The case began with a February 2024 NMC Fitness to Practise panel finding that Ms Stacey Jessica Nurrish’s fitness to practise was impaired due to multiple admitted acts of misconduct, including several involving dishonesty, such as working for one NHS trust while on sick leave from another, patient neglect, and a misrepresented COVID-19 test result. In recognition of her remorse, insight and the contextual pressure of an abusive relationship, the panel imposed a 12-month suspension with a review.

At the January 2025 review hearing (conducted virtually), a differently-constituted NMC panel took a very different view. That panel concluded that Ms Nurrish had been dishonest in her oral evidence before them, particularly about two character references she had provided, and decided that her fitness to practise remained impaired, imposing the ultimate regulatory sanction: striking her off the register.

Ms Nurrish appealed against the dishonesty finding and the sanction to the High Court. Her appeal centred on three key themes:

Procedural fairness: the review panel’s dishonesty finding was unsafe and procedurally unfair. Further, the manner of the panel’s questioning meant she gave answers which were then misconstrued.
The proper evaluation of evidence: the review panel failed to properly take account of her circumstances and the nature of the hearing.
Whether the sanction was proportionate and justified in light of the positive references which she had provided and the steps she had taken to remediate the impairment of her fitness to practise.

The High Court’s criticisms

The Court’s judgment highlighted several key deficiencies in the review panel’s approach:

Virtual hearings reduced reliability of demeanour assessments: the hearing was conducted remotely — a setting where evaluating witness nuance, body language and demeanour is inherently harder. The judge cautioned against giving undue weight to demeanour in virtual contexts, especially where stress and anxiety are evident.

The panel failed to warn about honesty being at issue: crucially, the panel never made it clear to Ms Nurrish that her honesty was in dispute. Indeed, some of the comments by the panel members gave the impression they were satisfied with Ms Nurrish’s answers. She was invited to make submissions generally, but was not put on notice that she should address alleged dishonesty or given the chance to respond directly. A fair process requires this transparency.

Questions were repetitive and contributed to confusion: the questioning was intense and repetitive: 44 direct questions in 22 minutes, often returning to the same topic after indications of panel satisfaction. The Court noted that such interrogation — without legal support for Ms Nurrish — can easily produce confusion misread as inconsistency. This was in addition to the hearing starting two hours later than expected, due to no fault of Ms Nurrish’s, which she said increased her nervousness and confusion and increased the likelihood of her making mistakes in her evidence.

Weak evidential foundation for dishonesty: the panel’s dishonesty finding rested largely on perceived inconsistencies between Ms Nurrish’s oral evidence and supportive references she had provided. But these inferences were neither tightly reasoned nor exclusive of innocent explanations (e.g. memory lapses, language interpretation) which the panel had not properly considered. The NMC’s representative had not suggested that Ms Nurrish’s evidence had been deliberately untruthful. The legal adviser did not provide nor was she asked to provide advice on the test for dishonesty nor did she give any warning as to the care which was needed in assessing oral evidence and in drawing inferences from the demeanour of a witness. As such, the finding of dishonesty was wrong and could not stand.

Taken together, these flaws meant the finding of deliberate dishonesty was unsafe and unfair, and could not support the conclusion that she remained impaired.

The judgment emphasised that procedural fairness is not a technicality—it is the backbone of professional discipline. The Court found that Ms Nurrish had not been given a fair opportunity to challenge certain aspects of the case against her, and that the panel’s approach created an appearance of imbalance.

The High Court accepted that the NMC has a wide margin of appreciation—but not an unlimited one. And in this case, the Court found that the Committee had crossed the line. On 2 January 2026, the court set aside both the dishonesty finding and the striking-off order, remitting the case to a differently constituted panel to reconsider both impairment and appropriate sanction.

Why Nurrish matters beyond this case: key takeaways for regulators, panels and practitioners

Explicitness is essential: panels must clearly notify parties when honesty or credibility is under scrutiny.
Remote hearings require caution: virtual formats change the dynamics of evidence assessment and demand heightened procedural care.
Representation matters: specialist legal support is not a luxury — it protects registrants from misinterpretation and ensures fairness.
Evidence and reasoning must align: a finding as serious as dishonesty can only stand on solid, carefully reasoned evidential grounds.

Conclusion

Nurrish reaffirms that professional regulation must be fair, reasoned, and proportionate, and that the High Court will intervene when those standards slip. This is particularly so where findings of dishonesty are made based on a panel’s evaluation of a witness’s testimony, given the serious consequences that flow from such a finding.

While regulators are rightly focused on protecting the public and maintaining professional standards, the High Court’s ruling is a reminder that those goals cannot trump procedural fairness. Healthcare professionals facing fitness to practise proceedings are at a significant disadvantage without legal representation — especially in complex hearings where credibility and insight are central issues.

In a system where careers, reputations, and public safety all hang in the balance, Nurrish is a timely reminder that justice must not only be done—it must be seen to be done.